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      Evidence-based practice implementation: The impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

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          Abstract

          Background

          The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use.

          Methods

          Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use.

          Results

          Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice.

          Conclusion

          This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.

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          Most cited references29

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          ORGANIZATIONAL INNOVATION: A META-ANALYSIS OF EFFECTS OF DETERMINANTS AND MODERATORS.

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            Perceived organizational support: a review of the literature.

            The authors reviewed more than 70 studies concerning employees' general belief that their work organization values their contribution and cares about their well-being (perceived organizational support; POS). A meta-analysis indicated that 3 major categories of beneficial treatment received by employees (i.e., fairness, supervisor support, and organizational rewards and favorable job conditions) were associated with POS. POS, in turn, was related to outcomes favorable to employees (e.g., job satisfaction, positive mood) and the organization (e.g., affective commitment, performance, and lessened withdrawal behavior). These relationships depended on processes assumed by organizational support theory: employees' belief that the organization's actions were discretionary, feeling of obligation to aid the organization, fulfillment of socioemotional needs, and performance-reward expectancies.
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              Evidence-based practice in psychology.

              (2006)
              The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophisticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005. Copyright 2006 APA, all rights reserved.
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                Author and article information

                Journal
                Implement Sci
                Implementation Science : IS
                BioMed Central
                1748-5908
                2009
                31 December 2009
                : 4
                : 83
                Affiliations
                [1 ]Department of Psychiatry, University of California, 9500 Gilman Drive #8012, San Diego, CA 92093-0812, USA
                [2 ]ICF Macro 116 John Street, Suite 800, New York, NY 10038, USA
                Article
                1748-5908-4-83
                10.1186/1748-5908-4-83
                2813227
                20043824
                ef89805a-21eb-4da9-8e34-0036f67c3a83
                Copyright ©2009 Aarons et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 September 2008
                : 31 December 2009
                Categories
                Research article

                Medicine
                Medicine

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